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00925njm 22002777a 4500 dc Ibáñez, Borja author Fernández-Ortiz, Antonio author Fernández-Friera, Leticia author García-Lunar, Inés author Andres, Vicente author Fuster, Valentin author 2021 Atherosclerosis starts early in life and progresses silently for decades. Considering atherosclerosis as a "systemic disease" invites the use of noninvasive methodologies to detect disease in various regions before symptoms appear. The PESA-(Progression of Early Subclinical Atherosclerosis) CNIC-SANTANDER study is an ongoing prospective cohort study examining imaging, biological, and behavioral parameters associated with the presence and progression of early subclinical atherosclerosis. Between 2010 and 2014, PESA enrolled 4,184 asymptomatic middle-aged participants who undergo serial 3-yearly follow-up examinations including clinical interviews, lifestyle questionnaires, sampling, and noninvasive imaging assessment of multiterritorial subclinical atherosclerosis (carotids, iliofemorals, aorta, and coronaries). PESA tracks the trajectories of atherosclerosis and associated disorders from early stages to the transition to symptomatic phases. A joint venture between the CNIC and the Santander Bank, PESA is expected to run until at least 2029, and its significant contributions to date are presented in this review paper. J Am Coll Cardiol . 2021 Jul 13;78(2):156-179. http://hdl.handle.net/20.500.12105/15205 34238438 10.1016/j.jacc.2021.05.011 1558-3597 Journal of the American College of Cardiology Progression of Early Subclinical Atherosclerosis (PESA) Study: JACC Focus Seminar 7/8.